Tools for Teaching Prenatal Yoga: The Third Trimester

By the last three months of her pregnancy, a mother is constantly aware of the baby inside her. Not only can she feel every kick and twist, but this little person is big enough to dramatically affect her body's functioning. A yoga class can provide an escape from both the physical and mental demands of the third trimester; the student can work on poses that relieve some of the strain on her body, and she can practice the mental focus required for giving birth.

"In the third trimester, because space is so compromised in a mama's body, the work of yoga is to make space in her body for her baby," says Jane Austin, a prenatal teacher at San Francisco's Yoga Tree Studio. "So doing poses that create a sense of openness, rather than of contraction, become the focus because she is preparing for her body to completely open."

Austin suggests letting the practice be a time to open mentally, as well. "We can hold that space for women to realize that it's not just their bodies that are changing, but who they are is fundamentally changing," she says. I tell them that every cell in their body is changed by being pregnant."

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Teaching a combination of modified asana, breathwork, and relaxation techniques will help a pregnant student anticipate her due date with confidence that she is well prepared for the challenge of labor.

The Physiology of the Third Trimester: Months Seven Through Nine

The third trimester is the final stage of pregnancy, culminating in labor and the birth of the child. By this point, the mother has probably gained between 20 and 30 pounds. (Although only a quarter of this weight is the actual baby—the rest is mostly the support equipment that keeps the baby alive.)

Extra weight can cause great discomfort. The pressure of the crowded uterus on the internal organs results in heartburn, frequent urination, lower back pain, cramping in the front and side abdominals, and shortness of breath. The large, unyielding mass of her belly causes interrupted sleep, difficulty moving, and clumsiness. The mother has unstable joints due to the hormone relaxin, which allows her pelvis to widen so that she can deliver, and may she experience dizziness as well as swelling in the hands and feet because of slowed circulation caused by the hormone progesterone.

In the last couple of months, the body prepares for the delivery. The mother will experience Braxton-Hicks contractions, or sporadic tightening of the uterine muscles, in practice for the muscle contractions during labor that push the baby out. The baby will drop down in the uterus toward the end of the ninth month, which can make walking and sitting difficult. In the last few weeks of the pregnancy, her cervix will begin to slowly open (dilate) and her pelvic floor will soften until she goes into labor—usually indicated by membranes rupturing (water breaking) and/or contractions becoming intense and more frequent.

All these dramatic changes, coupled with discomfort and anxiety about giving birth, can make this last trimester stressful for the mom-to-be. Debra Flashenberg, a teacher at the Prenatal Yoga Center in New York City, says, "Teaching women to trust their instincts is hard. Encourage them to listen. Let them really turn off the thinking mind and let their bodies lead them. Feel what's going on with the breath and get really internal."

Poses to Practice and Avoid in the Third Trimester

A yoga teacher can guide a student to explore poses that help her relax but also find strength. This work will later serve her during the intensity of birth. Roxi Thoren, an architecture professor in Eugene, Oregon, who is expecting her second child, found that having a mental catalogue to draw on during labor was one of the most useful aspects of her yoga class. She says, "I could think, 'Oh my lower back hurts, there's that pose or that stretch that will help.'"

The biggest concern with asana in this trimester is protecting the joints and maintaining balance. Even an experienced yogini will have to adapt to her quick weight gain and unbalanced shape. Basic standing and balance poses (Utthita Trikonasana [Extended Triangle Pose], Utthita Parsvakonasana [Extended Side Angle Pose], Virabhadrasana I and II [Hero I and II Poses], and Vrksasana [Tree Pose]) are good for building strength in the legs, reestablishing proper alignment in the spine, and encouraging circulation—but be sure to do them near the wall or with a chair, in case the student loses her balance.

"Challenging poses are not off the menu," says Austin. She suggests using the breath as a guide and a gauge of how the sequence is going for the student. "If, at any time, she finds her breath is compromised, she needs to shift the shape of the pose—she doesn't need to come out of the pose, but she needs to shift or take a rest so she can keep the smooth, steady breath."

Hip openers (Baddha Konasana [Bound Angle Pose] and Upavistha Konasana [Seated Wide-Legged Forward Bend Pose]) are also important asanas in this trimester because they help relieve aches in the lower back and create space around the pelvis. Not only do these poses help release the lumbar spine and open the hip joints but they are good positions to make the mother more comfortable during labor, too. Pelvic tilts can alternately tone (by lifting) and soften (by lowering) the pelvic floor, while Marjaryasana (Cat Pose) can help shift the baby lower in the uterus and may even encourage proper positioning (head down, face to the back).

Breath as a Teacher and Guide

Because a student in her third trimester has restricted mobility, her yoga practice can become quieter, with more emphasis on breathwork and less on asana. In fact, breathwork, or Pranayama, is a crucial part of a third trimester practice. Not only does it encourage relaxation but it also helps develop the ability to concentrate deeply. It can be done on its own, in a favorite hip-opening position (such as Supta Baddha Konasana [Reclined Bound Angle Pose], with pillows supporting the knees), or it can be used during asana practice to encourage focus.

Flashenberg uses breathwork to teach students to breathe evenly through a difficult pose. She says, "We'll do what I call the 'mock contraction,' which is Utkatasana (Chair Pose) done against the wall for 60 seconds, the length of the average contraction. I'll talk them through it: 'Relax your face, relax your jaw, move your breath.'" Students learn how breath can distract the mind from pain, which will be essential during labor.

Daina DeVoe, an obstetric nurse at Beloit Memorial Hospital in Beloit, Wisconsin, says the mental focus developed in a yoga class is an "absolute gift" during labor and delivery. "The breathing and the keeping of control through the pain is the most important thing. If they are doing any kind of focused breathing, I talk them through it to help them center and get better control of their pain during the pushing phase. Also, between the contractions, I have them rest with their breath, because often they will waste a lot of energy."

4 Tips for the Third Trimester

In the third trimester, the pregnant student is in the home stretch. This is the last time she will be able to focus only on herself for awhile, so help her enjoy the opportunity to concentrate on her own needs before the birth of her baby.

1. Encourage respect for her new shape. Students may be both amused and annoyed by the effect their growing bellies have on their ability to move. Make sure they have extra support, in case a pose becomes difficult. Even an experienced student hasn't done yoga while pregnant; the practice will be different.

2. Avoid inversions, backbends, and intense abdominal work. Many of these poses will be impossible, given the student's unbalanced shape. Don't let her overextend her already stressed joints and ligaments, especially in the torso.

3. Emphasize pranayama over asana. In the last trimester, intense focus is a talent to cultivate. Include hip and chest openers, alignment, and relaxation poses in the practice, but encourage breathwork in preparation for labor.

4. Use the breath as a vehicle to connect with the baby. Austin says, "I call it the 'secret message delivery service.' If teachers can help a woman connect to that baby and feel her breath feeding and fueling the baby, then she's going to use the practice to feel strong and centered and grounded. She's going to use her asana practice to literally be with her baby."

Expecting mother Roxi Thoren notes the progression of awareness during her own pregnancy. "There was a lot of quieting and centering at the beginning and end of class when (the teacher) talked about connecting with the baby, and I'd have to admit that at first it felt a little touchy-feely. Then later, when it began to be hard not to connect with the baby because she was kicking, I came to find it very comforting to be aware of what Ellie was doing. I was like, 'What are you up to in there?'"

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